Computing systems have greatly improved capability of businesses to track and manage collection of payments. The Internet provides a convenient medium for customers to make payments. Nevertheless, current billing systems lack functionality to provide features that would enhance effectiveness of payment collections for businesses. Similarly, current billing systems are fragmented and incomplete and lack functionality to provide features that provide a positive customer payment experience, thus producing confusion and frustration for customers and turning a positive experience into an overall negative experience with the business.
Collecting payments for goods and services provided is a critical function of businesses, particularly where it may be necessary or preferable to bill for services or products subsequent to providing them to a beneficiary (e.g., a customer). Convenience in making payments is of importance to many customers, and the payment experience for remitting payments for billed charges can significantly impact an impression of customers for a business. The healthcare industry is an industry in which billing and payment collection is fragmented and tends to produce a negative patient experience.
Current healthcare billing systems (sometimes referred to as Revenue Cycle Management (RCM) systems) are primarily designed to track claims and optimize payments by third-party payers (e.g., insurers). As a result, presently available healthcare billing systems present only vertical (period-based) portrayals of data and information. Specifically, the billing systems can tell a healthcare provider how much cash was collected this month but cannot tell how much of that cash was collected on balances created in any specific month prior as compared to those balances created this month. With only a vertical portrayal, a healthcare provider cannot accurately predict payment rates, understand vendor performance, set intelligent goals, offer intelligent financing, manage repayment risks, etc.
Presently available healthcare billing systems also are not equipped to elegantly manage patient (or guarantor) account balances. Patients/guarantors are generally confused by statements generated by existing billing systems. The patient/guarantor interfaces to billing systems, such as to make online bill payments, are fragmented and incomplete, turning a positive patient care experience into an overall negative experience with the healthcare provider. As an example, presently available healthcare billing systems do not present a guarantor a single electronic statement that includes all charges incurred for multiple disparate visits during a single period. As another example, a guarantor responsible for multiple different patients (e.g., dependents) generally cannot view an electronic aggregation of charges for visits of those different patients, especially over time. A guarantor also cannot link an account, or assume responsibility for an account, of another guarantor (e.g., a spouse) without a tedious paper request and approval process.
There is also a lack of flexible financing options for patients to pay for healthcare services. Similarly, there is a lack of flexible financing options for a variety of beneficiaries to pay for encounters providing goods and/or services, for which the encounter charges are billed to the beneficiary and/or a guarantor of the beneficiary.
There is also a lack of effective systems and methods for assessing the propensity of a guarantor to pay for a particular type of goods or services. For example, the credit scores generated by credit reporting agencies can be poor predictors or indicators of a guarantor's likelihood of paying for healthcare services. Similar shortcomings exist in other industries and markets, including but not limited to dental services, legal services, auto repair services, and other goods and services. Credit reporting agencies are largely dependent on data reported by credit lenders, and are often removed from actual transaction data in specific verticals like healthcare because few providers report payment dynamics to these agencies from actual transaction data. Thus, their credit scores may be limited to data based on transactions involving credit and for goods/services that may have nothing to do with a given market (e.g., healthcare services).